HLTH 5663 Module 5 Retention Strategy Paper Example

Why 38 Scientists Left in Three Years and What Would Have Kept Them: A Retention Argument Built on Workload, Schedules and a Way Up

Student Name

American College of Education

HLTH5663: Human Resources in Healthcare Organizations

Module 5 Assignment

Instructor Name

July 31, 2028

Why Retention Is the Lever That Matters

The workforce plan in Module 1 found that the composite system's laboratories face a shortfall of roughly fifteen scientist positions by year five on current trends, and that reducing turnover from 8 percent to 6 percent was one of three levers needed to close the gap. Retention also costs less than any other lever: each scientist who stays avoids about $60,000 in replacement costs and, often, months of premium-priced traveler coverage. Module 3 addressed pay. This module addresses the other reasons scientists leave.

Human resources reviewed exit interviews for all 38 scientists who left in the past three years, excluding retirements, and held stay interviews with 20 current scientists, asking what would make them leave and what keeps them. The most common primary reason for leaving was workload and short staffing, cited by 13 of 38, or 34 percent. Schedules, mainly rotating nights and weekends and mandatory overtime, were cited by 10, or 26 percent. Pay was cited by 8, or 21 percent, and the lack of any path to advancement by 5, or 13 percent. Two left for other reasons. Nineteen of the 38 left within their first three years. Pay was the reason a fifth of scientists gave for leaving; the other four-fifths left for reasons a raise will not touch.

What the Research Says About Burnout

The exit data match national findings. A survey of laboratory professionals by the American Society for Clinical Pathology found that job satisfaction was high but stress was high and burnout prevalent, and that the quantity of workload and understaffing were the main contributors (Garcia et al., 2020). Maslach and Leiter (2016) describe burnout as a response to chronic job stressors, with three dimensions, exhaustion, cynicism and a sense of ineffectiveness, and they locate its causes in mismatches between people and their work in six areas: workload, control, reward, community, fairness and values. The scientists' reasons for leaving map closely onto three of these: workload, control over schedules and reward, including recognition and advancement.

Interventions can work. West et al. (2016) pooled controlled and uncontrolled studies of efforts to lower burnout among doctors and found that both individual-focused and structural or organizational approaches produced meaningful reductions, with overall burnout falling from 54 percent to 44 percent across the studies. The evidence base for laboratory professionals is thinner, but the physician findings suggest that organizational changes, not only wellness programs, belong in the strategy.

Workload

The first set of actions reduces the work that falls on scientists. On nights, scientists at the community hospitals spend an estimated 12 percent of their time on specimen receipt, labeling and centrifuging, tasks that do not require a scientist's credentials. The system will add two laboratory assistant positions to take these tasks on nights, at a loaded cost of about $96,000 a year. It will also cap mandatory overtime at two extra shifts per scientist per month and publish the monthly count by laboratory, so that managers see where the cap is being tested.

At the community hospitals, where a single scientist can be alone with a trauma patient's blood bank work and routine testing, a second scientist will be placed on call on nights, paid a standby rate, and called in when the emergency department activates a trauma response. The previous module's case showed how solitary night work under pressure contributes to errors as well as exhaustion. These changes address workload directly, which the national survey and the exit data both identify as the leading cause of stress.

The strategy also states what it will not rely on. A wellness application, resilience training or an appreciation week would cost little and might help some individuals, but none addresses the reasons scientists gave for leaving, and offering them in place of staffing changes risks confirming the cynicism that Maslach and Leiter (2016) identify as a core dimension of burnout. Individual supports will be offered alongside the organizational changes, never as a substitute for them. The 12 percent estimate of time spent on specimen processing comes from a two-week work sampling study on the night shift at both community hospitals, in which a supervisor recorded each scientist's activity at random intervals, and it will be repeated after the assistants start to confirm that the time actually moved.

Scheduling

The second set gives scientists more control over when they work. The laboratories will move from manager-built schedules to self-scheduling within rules: each scientist chooses shifts in a six-week schedule, subject to minimum staffing for each shift and a fair rotation of holidays. Scientists will be offered permanent shift options, including permanent nights with the higher night differential from Module 3, instead of rotation. Several stay interview participants said they would prefer permanent nights if the pay reflected it. Weekend requirements will fall from every other weekend to every third weekend once the traveler conversions increase staffing.

Control over schedules is one of the six areas in which Maslach and Leiter (2016) locate the sources of burnout, and it costs relatively little. Self-scheduling requires a scheduling tool the system already licenses for nursing and about eight hours of supervisor time per schedule period to resolve gaps.

Career Growth

The third set gives scientists a reason to stay for their next five years, not only their next shift. The three-level career ladder priced in Module 3 provides recognized progression through specialty competency and training roles. The system will add support for specialist certification, paying examination fees and providing paid study time, and a lead scientist role on each shift at the regional center. It will offer six-month rotations into the molecular testing section the system is planning, so that scientists interested in newer methods do not need to leave to learn them. Because nearly half of departures occur in the first three years, new scientists will be assigned a mentor from level II or III for their first year, with the mentoring counted toward the mentor's own ladder requirements.

Cost, Owners and Measures

Excluding the pay package already costed, the retention actions cost about $150,000 a year: $96,000 for the assistants, about $30,000 in on-call standby pay and about $24,000 for certification support and mentoring time. Reducing turnover from 8 percent to 6 percent would prevent about 1.2 departures a year, saving about $72,000 in replacement costs and, in the current market, avoiding traveler coverage that costs about $73,000 per position per year. If each avoided departure also avoids six months of traveler coverage, the savings come to about $116,000, roughly three-quarters of the cost, before counting the value of fewer errors, fewer uncovered night shifts and less overtime for the scientists who remain. The laboratory director owns workload and scheduling, the human resources business partner owns career growth and mentoring and both report quarterly.

The measures are turnover by tenure band, with first-three-year turnover as the most important; the count of mandatory overtime shifts; results from an annual single-question burnout measure; and repeated stay interviews each year. If first-three-year turnover has not fallen within 18 months, the team will return to the exit data before adding new programs.

References

Garcia, E., Kundu, I., Kelly, M., Soles, R., Mulder, L., & Talmon, G. A. (2020). The American Society for Clinical Pathology's job satisfaction, well-being, and burnout survey of laboratory professionals. American Journal of Clinical Pathology, 153(4), 470-486. https://doi.org/10.1093/ajcp/aqaa008

Maslach, C., & Leiter, M. P. (2016). Understanding the burnout experience: Recent research and its implications for psychiatry. World Psychiatry, 15(2), 103-111. https://doi.org/10.1002/wps.20311

West, C. P., Dyrbye, L. N., Erwin, P. J., & Shanafelt, T. D. (2016). Interventions to prevent and reduce physician burnout: A systematic review and meta-analysis. The Lancet, 388(10057), 2272-2281. https://doi.org/10.1016/S0140-6736(16)31279-X